<?php echo form_open($this->curl . '/create/', 'id="myform" name="myform" autocomplete="off"')?>
<br />
<table class="nostyle" width="100%" border="0" cellpadding="0" cellspacing="0">
<tr>
	<td>
		<?php echo $this->validation->error_string?>
		<table class="nostyle forma" width="100%" border="0" cellpadding="3" cellspacing="0">
		<tr style="height: 50px; color:#c00000;";>
			<td>Private Data</td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['first_name']?></th>
			<td><div class="input_300"><?php echo form_input('first_name', $this->validation->first_name, 'class="input-text"')?></div></td>
		</tr>			
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['last_name']?></th>
			<td><div class="input_300"><?php echo form_input('last_name', $this->validation->last_name, 'class="input-text"')?></div></td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['phone']?></th>
			<td><div class="input_300"><?php echo form_input('phone', $this->validation->phone, 'class="input-text"')?></div></td>
		</tr>	
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['email']?></th>
			<td><div class="input_300"><?php echo form_input('email', $this->validation->email, 'class="input-text"')?></div></td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['password']?></th>
			<td><div class="input_300"><?php echo form_password('password', $this->validation->password, 'class="input-text" size="20"')?></div></td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['password_confirm']?></th>
			<td><div class="input_300"><?php echo form_password('password_confirm', $this->validation->password_confirm, 'class="input-text" size="20"')?></div></td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['acl_role']?></th>
			<td><div class="input_300"><?php echo form_dropdown('acl_role', $this->config->item('user_acl_roles'), array($this->validation->acl_role), null, TRUE)?></div></td>
		</tr>
		<tr>
			<th><?php $this->load->view('_elements/obligatory');?><?php echo $this->user_model->fields['status']?></th>
			<td><div class="input_300"><?php echo form_dropdown('status', $this->user_model->status, array($this->validation->status), null, TRUE)?></div></td>
		</tr>
		<tr style="height: 50px; color:#c00000;";>
			<td>Else Data</td>
		</tr>	
		<tr>
			<th><?php echo $this->user_model->fields['city']; ?></th>
            <td><div class="input_300"><?php echo form_input('city', $this->validation->city, 'class="input-text"')?></div></td>
        </tr>
        <tr>
			<th><?php echo $this->user_model->fields['address']; ?></th>
            <td><div class="input_300"><?php echo form_input('address', $this->validation->address, 'class="input-text"')?></div></td>
        </tr> 
        <tr>
        	<th><?php echo $this->user_model->fields['country_ID']; ?></th>
        	<td><div class="input_300"><?php echo form_dropdown('country_ID', $this->geo_country_model->getSelectOptions(), '', 'id="id_geo_countries" onchange="loadStates(this.value, \'place_states\')"', TRUE)?></div></td>
        </tr>
        <tr id="place_states">
        
        </tr>
        <tr>
			<th><?php echo $this->user_model->fields['zip_code']?></th>
			<td><div class="input_300"><?php echo form_input('zip_code', $this->validation->zip_code, 'class="input-text"')?></div></td>
		</tr> 
		<tr>
			<th><?php echo $this->user_model->fields['payment_method']; ?></th>
             <td><div class="input_300"><?php echo form_dropdown('payment_method', $this->config->item('paymentMethod'), array($this->validation->payment_method), null, TRUE)?></div></td>
		</tr>
        <tr>
			<th><?php echo $this->user_model->fields['card_type']; ?></th>
             <td><div class="input_300"><?php echo form_dropdown('card_type', $this->config->item('cardTypeitem'), array($this->validation->card_type), null, TRUE)?></div></td>
		</tr>
		<tr>
			<th><?php echo $this->user_model->fields['card_number']; ?></th>
            <td><div class="input_300"><?php echo form_input('card_number', $this->validation->card_number, 'class="input-text"')?></div></td>
        </tr>
        <tr>
        	<th><?php echo $this->user_model->fields['exp_date']; ?></th>
        	<td>
        		<div class="input_300">
        			<?php echo form_dropdown('exp_month', $this->config->item('months'), array($this->validation->exp_month), null, TRUE)?>
        			<?php echo form_dropdown('exp_year', $this->config->item('expYearitem'), array($this->validation->exp_year), null, TRUE)?>
        		</div>
        	</td>
        </tr>
        <tr>
			<th><?php echo $this->user_model->fields['security_code']?></th>
			<td><div class="input_300"><?php echo form_input('security_code', $this->validation->security_code, 'class="input-text"')?></div></td>
		</tr>
		<tr>
			<td colspan="2">&nbsp;</td>
		</tr>
		<tr>
			<td></td>
			<td>			
				<input name="edit" type="submit" class="btn btn_save" id="submit" value="<?php echo T_('Submit')?>" />
				<input name="reset"  type="reset"  class="btn btn_clear" id="reset" value="<?php echo T_('Reset')?>" onclick="$('#create_form input[type=text]').val('');" />
			</td>
		</tr>
		</table>
	</td>
</tr>
</table>

<?php echo form_close()?>